Jackson, Lori K

Jackson, Lori K is an individual health care provider with primary practice located at 300 Main St , Lewiston ME 04240-7027. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Lori K can be contacted via phone (207) 795-0111.

Contact Information

Primary practice address
300 Main St Lewiston ME 04240-7027
Phone: (207) 795-0111
Fax: (207) 795-2766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA852 Maine

Profile Details

NPI number 1912965880
LBN Legal business name Jackson, Lori K
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated Jun 3rd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912965880 NPPES
Maine MEDICAID 1912965880

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